Comprehensive cross-platform comparison of methods for non-invasive EGFR mutation testing : results of the RING observational trial.
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Romero Alfonso, Atocha; Jantus Lewintre, Eloisa; García-Peláez, Beatriz; Royuela, Ana; Insa Mollá, Amelia; Cruz, Patricia; Collazo, Ana; Pérez Altozano, Javier; Juan Vidal, Óscar José; Diz Taín, Pilar; Cobo, Manuel; Hernández Marín, Berta; Vázquez Estévez, Sergio; Benítez, Gretel; Guirado, Maria; Majem, Margarita; Bernabé, Reyes; Ortega, Ana Laura; Blasco Cordellat, Ana; Bosch Barrera, Joaquim; Jurado, José María; García González, Jorge; Viteri, Santiago; García Girón, Carlos; Massuti Sureda, Bartomeu; López Martín, Ana; Rodríguez Festa, Alejandro; Calabuig-Fariñas, S.; Molina Vila, Miguel Ángel; Provencio Pulla, Mariano
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Aquest document és un/a article, creat/da en: 2021
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Abstract Several platforms for noninvasive EGFR testing are currently used in the clinical setting with sensitivities ranging from 30% to 100%. Prospective studies evaluating agreement and sources for discordant results remain lacking. Herein, seven methodologies including two next-generation sequencing (NGS)-based methods, three high-sensitivity PCR-based platforms, and two FDA-approved methods were compared using 72 plasma samples, from EGFR-mutant non-small-cell lung cancer (NSCLC) patients progressing on a first-line tyrosine kinase inhibitor (TKI). NGS platforms as well as high-sensitivity PCR-based methodologies showed excellent agreement for EGFR-sensitizing mutations (K = 0.80-0.89) and substantial agreement for T790M testing (K = 0.77 and 0.68, respectively). Mutant allele frequencies (MAFs) obtained by different quantitative methods showed an excellent reproducibility (intraclass correlation coefficients 0.86-0.98). Among other technical factors, discordant calls mostly occurred at mutant allele frequencies (MAFs) ≤ 0.5%. Agreement significantly improved when discarding samples with MAF ≤ 0.5%. EGFR mutations were detected at significantly lower MAFs in patients with brain metastases, suggesting that these patients risk for a false-positive result. Our results support the use of liquid biopsies for noninvasive EGFR testing and highlight the need to systematically report MAFs. Keywords: NGS; circulating free DNA; epidermal growth factor receptor; non-small-cell lung cancer; osimertinib; tyrosine kinase inhibitor.
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